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Stockton Maintenance Group SMG #1
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(08-06-02) Janitorial Maint. Svcs,
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Stockton Maintenance Group SMG #1
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Last modified
3/10/2011 4:43:56 PM
Creation date
3/10/2011 4:06:22 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Janitorial Maint. Svcs.
Bid No. (xx-xx-xx)
08-06-02
Project Type (Bid, RFP, RFQ)
Bid
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<br />to l' <br /> <br />SECTION 21 <br />ANn-KICKBACK AFFIDAVIT <br /> <br />STATE OF FLORIDA ) <br />COUNTY OF ~ ~Ij~l~ <br /> <br />I, the undersigned, hereby duly sworn and deposed say that no portion of this sum <br />herein bid will be paid to any employees of the City of Sunny Isles Beach or its elected <br />officials as a commission, kickback, reward or gift, directly or indirectly by me or any <br />member of my firm or by an officer of the corporation. <br /> <br />By: ~~~ <br /> <br />Title: fll~~ In 'Z-Nr <br /> <br /> <br />The foregoing instrument wa~acknowle~ before me this /1 day of <br />~ by U at.Li~ <t 0 /La A-,J <br />ame of person], as Ie E'S ( 9 EN r [type of authority], for <br />;Sft>Cf~n:;,.::J A-lA-T NT. (~iJLl.O [name of party on behalf of whom instrument <br />was executed]. r <br /> <br /> <br />~ "!'.I. Notary Public State of Florida <br />R ~p~ Elaine Moschetti <br />;..~. _'> ,; My Commission D0747355 <br />"YJ> ~ Expires 03101/2012 <br />or;\' Print or Typ <br /> <br /> <br />Personally Known X OR Produced Identification <br />Type of Identificat~ <br /> <br /> <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />END OF SECTlON <br /> <br />PAGE 77 OF 78 <br />
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